Prince M, Szer J, van der Weyden M B, Pedersen J S, Holdsworth R F, Whyte G
Alfred Hospital, Melbourne, Vic., Australia.
Aust N Z J Med. 1991 Feb;21(1):43-6. doi: 10.1111/j.1445-5994.1991.tb03000.x.
A 63-year-old patient developed graft-versus-host disease (GVHD) after the transfusion of stored, random donor red cell concentrates with coronary artery surgery. The disease was characterised by skin rash, fever, diarrhoea, hepatic dysfunction, pancytopenia and the acquisition of cells bearing human leukocyte antigens of a blood donor. Clinical and histologic improvements were noted with antithymocyte-globulin and corticosteroid therapy, as seen in some patients with acute GVHD following allogeneic bone marrow transplantation, but the pancytopenia failed to resolve prior to a fatal cerebral haemorrhage. Early aggressive immunosuppressive therapy may be beneficial for transfusion-associated GVHD but strategies for its prevention by limitation of the use of homologous blood need to be addressed.
一名63岁患者在冠状动脉手术中输注储存的随机供体红细胞浓缩物后发生移植物抗宿主病（GVHD）。该疾病的特征为皮疹、发热、腹泻、肝功能障碍、全血细胞减少以及获得带有献血者人类白细胞抗原的细胞。使用抗胸腺细胞球蛋白和皮质类固醇治疗后，临床和组织学均有改善，这在一些异基因骨髓移植后的急性GVHD患者中也可见，但在致命性脑出血前全血细胞减少未能缓解。早期积极的免疫抑制治疗可能对输血相关的GVHD有益，但需要探讨通过限制同源血使用来预防该病的策略。
